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General NPI Number Information
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NPI Number | 1477150597
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Entity Type | Organization
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Legal Business Name | ANCHOR PHYSICAL THERAPY & WELLNESS, PLLC
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Dates
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Enumeration Date | 10/01/2020
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Last Update Date | 10/01/2020
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Provider Practice Location Address
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Address Line | 1020 NANCY ST
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City | FORT MORGAN
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State | CO
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Zip | 80701-3726
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Country | US
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Telephone | 719-580-4076
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Fax |
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Provider Business Mailing Address
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Address Line | 1020 NANCY ST
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City | FORT MORGAN
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State | CO
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Zip | 80701-3726
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Country | US
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Telephone | 719-580-4076
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | STEPHANIE LEE MICKLICH
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Credential | PT, DPT
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Telephone | 719-580-4076
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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